| NPI | 1558518985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 13253942-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101247449) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2023-06-14 |